The following information must be viewed as a guide only. It is not intended, nor implied to be a substitute for professional medical advice.
Specific recommendations on vaccinations, antimalarial medications & targeted travel health advice are always provided on an individual basis taking into account:
Some vaccines eg rabies & tuberculosis are also very much influenced by local disease risk. Specific face-to-face advice is particularly important when recommending antimalarial medications & those for presumptive treatment eg for traveller’s diarrhea.
We strongly recommend travellers seek an appointment with a doctor trained in travel health prior to departure. It is recommended that you visit a travel health professional 6-8 weeks prior to departure. However, if that time frame is not possible, remember , It’s never too late to vaccinate’.
Nepal is a popular destination for adventurous travellers. The country, though small offers a variety of attractions from elephant rides & encounters with tigers in the Chitwan and Bardia National Parks, a variety of rafting trips, through popular trekking in the foothills of Everest or the Annapurna, to serious high-altitude climbing. It really offers something for everyone.
Pre-travel preparation will help protect your health while you are away. To assist you in recognizing & understanding some of the major travel health risks you may face while holidaying in Nepal. The below information provides a brief description of some of the major travel health issues & vaccinations that should be considered for travel to Nepal.
We hope you find this information useful in preparing for your trip. Remember it is advisable to consult a travel health specialist prior to departure.
Hepatitis A
This is a viral disease of the liver which is transmitted through eating contaminated food or drinking contaminated water. It is the most common vaccine preventable disease that occurs in travellers to less developed areas of the world. It is strongly recommended for travel to Nepal.
Hepatitis B
This is a viral disease of the liver that is transmitted via blood, blood products or bodily fluids. It is vaccine preventable. Hepatitis B immunization is now part of the childhood immunization schedule. Many adult travellers have missed this very important immunization & travel may be a good reason for vaccination.
Typhoid
Typhoid Fever is caused by a bacteria found in contaminated food & water. It is endemic in the developing world & vaccination is recommended for travellers to areas where environmental sanitation & personal hygiene may be poor. The adventurous eater venturing off the beaten path should certainly consider vaccination.
Tetanus, Pertussis & Diphtheria
Tetanus is caused by a toxin released by a common dust or soil bacteria, which enters the body through a wound. Diphtheria is a bacterial infection of the throat & occasionally of the skin. It is found worldwide & is transmitted from person-to-person by coughing & sneezing. Pertussis (Whooping cough) is a highly infectious respiratory infection responsible for 300,000 deaths annually, mainly in children. Diphtheria & pertussis vaccines can be added to the tetanus vaccine. Because many adults no longer have immunity from childhood immunization it is advised that travellers to less developed countries have a tetanus, diphtheria & pertussis booster.
Measles, Mumps & Rubella
Childhood immunization coverage in many developing countries is not very good. As such, travellers whose birth date is after 1966 should check they have had 2 doses of measles vaccine. Since 1990 this may have been as the combination vaccine MMR (measles, mumps & rubella). Those born prior to 1966 are most likely to have long term immunity from previous exposure as a child.
Chickenpox
This very common infectious disease can now be prevented through immunization. Many people miss the disease in childhood only to have a significant illness as an adult. Travel puts one at higher exposure & if one cannot elicit a history of having had the illness a test can show whether at risk.
Influenza
Individuals intending to travel out of an Australian winter might consider the current flu vaccine at the beginning of the season. Exposure to illness in airports & commuter transport is common & exposure may ruin a much needed break. In fact, influenza is likely to be the most common vaccine preventable disease faced by travellers.
Poliomyelitis
All travellers to Nepal should be up to date with vaccination against polio. Poliomyelitis is a viral infection that can lead to paralysis & sometimes death. Transmission is by faecal contamination of food, usually by unhygienic food handlers or flies, or directly from infected nasal secretions. Polio is no longer endemic in Nepal, but imported cases from India do occur. Although most Australian’s & New Zealanders will have been immunized in childhood, it is important to note that efficacy wanes after 10 years & a booster dose is recommended if travelling to a country where the disease can still be found.
Malaria
Malaria is transmitted by a night biting mosquito. The decision to use or not use anti-malarial drugs should be made after consultation with a travel health specialist, taking into consideration the relative malaria risk of areas on the traveller’s itinerary as well as potential side effects & cost of available drugs. Insect avoidance measures should be followed throughout the trip. Upon return, any flu like illnesses should be investigated by a travel health specialist. See below.
Meningitis
Meningitis is an inflammation of the membrane overlaying the brain. It can be caused by bacteria, a virus or a fungus. Bacterial meningitis is the form of most concern to travellers. It is a serious disease & can rapidly become life threatening. It is transmitted from person-to-person through close contact (ie droplet infection the same way you catch a cold). Vaccination might be considered for those backpacking off the beaten path or those working in health areas where crowded conditions occur. The tea house accommodation in most of the treks in Nepal is conducive to the spread of meningitis & epidemics occur sporadically.
Japanese Encephalitis (JE)
JE is a mosquito borne viral disease prevalent in rural areas of Asia that can lead to serious brain infection in humans. Risk is usually greatest during the monsoon months. A vaccine is available & is particularly recommended for adults & children over 12 months of age who will be spending a month or more in rice growing areas of countries at risk (or who repeatedly visit such areas). It is also recommended for people travelling to an area where an outbreak is known to be occurring. Insect avoidance should be considered the primary means of defence. The risk is higher in the southern lowlands bordering India (Terai).
Rabies
Rabies is a deadly viral infection of the brain transmitted to humans. The disease itself is rare in travellers, but the risk increases with extended travel & the likelihood of animal contact. The best way to avoid rabies is too avoid all contact with animals. Dogs are the main carriers; however monkeys, bats, cats & other animals may also transmit the disease. Pre-exposure vaccination is recommended for extended travel & those who work with, or are likely to come in contact with animals.
Cholera
Cholera is a severe, infectious diarrhoeal disease caused by bacteria. It is common in developing countries & is associated with conditions of poverty & poor sanitation. Cholera causes severe & rapid dehydration. Travellers who follow the rules of eating & drinking safely will minimize their risk. There is also a new oral vaccine available for cholera which may be recommended under certain circumstances.
Traveller’s Diarrhoea
Up to 40% of tourists may develop 3 or more loose bowel motions a day within the first week of travel. A variety of germs can be responsible for this infection & a Traveller’s Medical Kit containing appropriate therapy can rapidly improve the symptoms. It is also important to follow the rules of healthy eating & drinking to minimize risks. The new oral cholera vaccine has been shown to provide limited protection against some forms of traveller’s diarrhoea.
